Acupuncture & Chinese Medicine ● Longevity Nutrition

telomeres

Inflammation is not the underlying root of any disease. It is a side effect of a deeper cause. Tinkering with inflammation is tinkering with the immune system. Buzzwords like “anti-cancer”, “anti-viral”, “anti-inflammation” and “immune-boosting” are misleading and offer no information about how various herbs, supplements and pharmaceuticals actually work. Desperate for relief, ill consumers are constantly duped by the supplement industry as they seek easy answers for complex diseases. When the mechanism of a supplement doesn’t match the underlying cause of the immune imbalance, short-term side effects commonly occur. An understanding the mechanisms of aging offers us a glimpse of the potential short-term and long-term side effects that can result from tinkering with the immune system.

When I began studying functional medicine 18 years ago, I was awakened to the then controversial hypothesis that inflammation was the primary driver of many of the diseases of aging. There were hundreds of studies demonstrating the correlation between inflammation and conditions like heart disease, obesity, diabetes, cancer and even aging. As I developed my practice, it was like having magical powers believing that the cause of heart disease was not cholesterol but, in fact, inflammation. Armed with supplements like fish oil, curcumin and boswellia, I felt like Wonder Woman, striking down interleukin 6, NF-kappa B, TNFα and other inflammatory signals that could lead to disease. It wasn’t until I began treating autoimmune and skin disorders that I came to realize that inflammation is not the underlying root of any of these diseases. It’s a side effect of a deeper cause. In fact, suppressing inflammation without understanding its cause is as insane as turning off the fire alarm and going back to bed while the house fills with smoke.

There are four core mechanisms that drive inflammation.  This article will explore the most common; when the immune system recognizes something as an invader and launches an attack using inflammatory chemicals as weapons. In science we call this immune system activation by antigen recognition.

The other three (listed below) will be discussed in future posts.

  • Over activation of NFKappaB through dietary signaling. Activity of NFKappa B is highly influenced by the presence or absence of insulin[1]. In general, diet doesn’t cause inflammation; it simply acts like a volume control.  It isn’t until grossly pathological changes develop through excessive insulin signaling and ROS production that we begin to see the out-of-control inflammation associated with diseases like obesity and diabetes.
  • Deranged methylation and acetylation of DNA[2],[3]. Basically methyl groups (from SAMe) and acetyl groups are stuck to DNA to turn it on and off.
  • The healing response – the redness, pain and swelling that results from an injury is ultimately an immune response that drives healing. However, repeated injuries, like when high blood pressure repeatedly damages the arteries, will lead to thickening and scarring.

Much of inflammation is nothing more than a side effect of immune activity. A fundamental flaw in our current medical approach to inflammation is the false belief that the immune system is creating inflammation for no reason.   As a result, we have an entire industry of herbs, supplements and pharmaceuticals built upon the idea that suppressing inflammation is somehow healing the body. All this despite several large studies demonstrating that conditions associated with inflammation like heart disease[4], diabetes[5] and cancer[6] are mostly driven by external factors. To be clear, unless a true[7] autoimmune condition has developed, the immune system will not act unless there is something triggering it to act. Sometimes we don’t like the results. However, this ancient system that protects us from cancer and invaders is highly intelligent and tightly regulated. The immune system will launch an attack against any critters or substance that it identifies as an invader. These include bacteria, viruses, air pollutants, some metals, environmental contaminants and oxidized LDL cholesterol[8]. It will also attack undigested food proteins like gluten from wheat and lectins from beans. Food sensitivity tests like the ALCAT and Mediator Release Test (MRT) regularly reveal that the immune system will attack virtually any intact food protein or microbe that escapes past the protective gut mucosa (gut lining).

As one example in an ocean of inflammatory immune signals, look at what happens if we tinker with TNFα.

T= “tumor” like cancer

N=“necrosis” like death

Fα=“factor alpha” as a signal category

TNFα is an inflammation weapon produced by certain immune cells to protect us from viruses and cancer. It helps transmit signals from outside a cell to inside a cell’s nucleus where more signals tell the cell to kill itself. In science we call this apoptosis. It is helpful for ensuring that cells that have become cancerous do not survive to divide and grow into a tumor. TNFα also “serve[s] as a first-line defense against influenza virus[9]” and has “strong antiviral activity against many viruses including avian flu and swine flu2”. Upon first glance, it sounds like anything that will increase activity of TNFα can keep you from getting cancer and viruses. Woohoo! In fact, several medicinal mushrooms are promoted as having these anti-cancer and anti-viral properties. Cordyceps[10],[11], Maitake[12], Coriolus[13] and Ganoderma[14], all contain chemicals that increase activity of TNFα*. While this approach can be transformative for someone with a weak immune response, what effects does artificially increasing TNFα have in a healthy person?   We know that in high amounts, TNFα causes considerable collateral damage to tissues. It is one of the main participants in diseases like psoriasis[15], ulcerative colitis[16] and rheumatoid arthritis[17]. Moderately high levels are associated with Alzheimer’s disease[18] and even cancer10.

*I suspect that these mushrooms cause an increase in TNFα, not because they have magical properties, but because the immune system sees them as invaders and launches an attack.

Over the long term, does artificially raising TNFα activity accelerate the same degenerative problems that we see with any chronic inflammation? Wouldn’t mildly elevated levels still increase cell turnover, damage tissues, accelerate shortening of telomeres, speed aging and ultimately lead to early senescence*?

(*Senescence is a term used in aging research to describe the end stage of the aging process of a cell, tissue or system. When a cell reaches senescence it can no longer function properly or divide to form new cells. As more cells reach senescence in a given tissue, the more that tissue shrinks and becomes dysfunctional.)

Unless there is a specific reason to artificially stimulate TNF-alpha, it is important to weigh the potential effects of taking any herbs or mushrooms that raise it. Other herbs that stimulate inflammation by raising TNFα include Cistanches, Dipsacus, Echinacea and Psoralea. I have personally seen several patients whose autoimmune conditions were severely exacerbated from taking medicinal mushrooms. They were duped by claims and promises that somehow their condition was a result of a “weak” immune system and that these mushrooms were their salvation. On the other hand, with proper diagnosis, these types of mushrooms can be used as an effective tool when the immune response is too weak. Poor wound healing and recurrent viral infections (like shingles and Epstein Barr) are often caused by a weak immune response. Another scenario where these mushrooms may have benefit is with cancer. I have worked with scores of patients who were doing well months after their doctor prescribed Maitake-D as part of a larger protocol to help the immune system kill cancer cells. (Notice I said “part of a protocol”).

In the ocean of herbs and supplements that are supposed to help us live longer and healthier, how do we know which ones are actually helping? With illness, when the mechanism of a supplement doesn’t match the underlying cause of an immune imbalance short-term side effects commonly occur. What are the less detectable the long-term consequences? Is it possible to accelerate the aging process by inappropriately stimulating the immune system?

 

[1] Kurtak, K. Dietary and Nutritional Manipulation of the Nuclear Transcription Factors, PPAR’s and SREBP’s,as a Tool for Reversing the Primary Diseases of Premature Death and Aging. Rejuvenation Research 17-2. April 2014. P 140-44.

[2] D. Bayarsaihan Epigenetic Mechanisms in Inflammation J Dent Res. 2011 Jan; 90(1): 9–17. doi:  10.1177/0022034510378683 PMCID: PMC3144097

[3] Stephen B Baylin DNA methylation and gene silencing in cancer. Nature Clinical Practice Oncology (2005) 2, S4-S11 doi:10.1038/ncponc0354. Received 16 August 2005 | Accepted 30 August 2005

[4] Prof Salim Yusuf DPhil,Steven Hawken MSc,Stephanie Ôunpuu PhD,Tony Dans MD,Alvaro Avezum MD,Fernando Lanas MD,Matthew McQueen FRCP,Andrzej Budaj MD,Prem Pais MD,John Varigos BSc,Liu Lisheng MD,on behalf of the INTERHEART Study Investigators Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study

The Lancet – 11 September 2004 ( Vol. 364, Issue 9438, Pages 937-952 )

DOI: 10.1016/S0140-6736(04)17018-9

[5] Dariush Mozaffarian, MD, DrPH; Aruna Kamineni, MPH; Mercedes Carnethon, PhD; Luc Djoussé, MD, ScD; Kenneth J. Mukamal, MD; David Siscovick, MD, MPH. Lifestyle Risk Factors and new Onset Diabetes Mellitus in Older Adults. Arch Intern Med. 2009;169(8):798-807. doi:10.1001/archinternmed.2009.21.

[6] Song Wu, Scott Powers, Wei Zhu & Yusuf A. Hannun. Substantial contribution of extrinsic risk factors to cancer development. Nature (2015) doi:10.1038/nature16166

Received 15 April 2015 Accepted 23 October 2015 Published online 16 December 2015

[7] From experience I have no doubt that many conditions that are diagnosed as “autoimmune” are nothing more than an appropriate immune reaction to an unidentified trigger that has grown out of control.   This is commonly seen with leaky gut syndrome, SIBO and dental infections.

[8] Although there are hundreds of studies showing that oxidized LDL elicits inflammation from macrophages, it has never been shown whether this is an immune reaction or a healing response.

[9] Seo SH, Webster RG. Tumor necrosis factor alpha exerts powerful anti-influenza virus effects in lung epithelial cells. J Virol. 2002 Feb;76(3):1071-6.

[10] Test on mononuclear cells Lymphoproliferative, inhibited NK cell activity, phytohemagglutinin response raises IL2, raises TNF-alpha, IL-2   Kuo YC1, Tsai WJ, Shiao MS, Chen CF, Lin CY. Cordyceps sinensis as an immunomodulatory agent. Am J Chin Med. 1996;24(2):111-25.

[11] Jong Seok Lee, Eock Kee Hong. Immunostimulating Activity of the Polysaccharides Isonated from Cordyceps militaris. International Immunopharmacology. Vol 11, Isue 9, September 2011 Pp 1226-1233 doi:10.1016/j.intimp.2011.04.001

[12] Matsui K1, Kodama N, Nanba H. Effects of maitake (Grifola frondosa) D-Fraction on the carcinoma angiogenesis. Cancer Lett. 2001 Oct 30;172(2):193-8.

[13] Cheuk-Lun Lee, Xiaotong Yang, Jennifer Man-Fan Wan. The culture duration affects the immunomodulatory and anticancer effect of polysaccharopeptide derived from Coriolus versicolor. Enzyme and Microbial Technology. Volume 38, Issues 1–2, 3 January 2006, Pages 14–21

[14] Hung-Sen Chena, Yow-Fu Tsaia, Steven Lina, Chia-Ching Lina, Kay-Hooi Khoo, Chun-Hung Lin , , Chi-Huey Won. “Studies on the immuno-modulating and anti-tumor activities of Ganoderma lucidum (Reishi) polysaccharides”. Bioorganic & Medicinal Chemistry Volume 12, Issue 21, 1 November 2004, Pages 5595–5601

[15] Victor FC, Gottlieb AB (2002). “TNF-alpha and apoptosis: implications for the pathogenesis and treatment of psoriasis”. J Drugs Dermatol 1 (3): 264–75. PMID 12851985.

[16] Sands BE1, Kaplan GG The role of in ulcerative colitis.. J Clin Pharmacol. 2007 Aug;47(8):930-41. Epub 2007 Jun 13.

[17] VASANTHI, P., NALINI, G. and RAJASEKHAR, G. (2007), Role of tumor necrosis factor-alpha in rheumatoid arthritis: a review. APLAR Journal of Rheumatology, 10: 270–274. doi: 10.1111/j.1479-8077.2007.00305.x

[18] Swardfager W, Lanctôt K, Rothenburg L, Wong A, Cappell J, Herrmann N (2010). “A meta-analysis of cytokines in Alzheimer’s disease”. Biol Psychiatry 68 (10): 930–941. doi:10.1016/j.biopsych.2010.06.012. PMID 20692646.

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When we think of ageing we assume that our body’s various tissues all age at the same rate.  In fact this is not so.  Various stresses over a lifetime will cause different tissues to age at different rates. 

  There are three inter-related factors that ultimately determine ageing of cells in a specific tissue.

  • Telomere length  the ultimate determining factor.  Very briefly, telomeres are like caps on the ends of chromosomes that protect them from deterioration.  Every time a cell divides, the telomere shortens.  When the telomeres are gone, the cell can no longer reproduce itself. Once this happens they age and eventually die. (Or become cancerous and become temporarily immortal)
  • Rate of cell turnover or replication.  Cell turnover is necessary for eliminating old cells which often contain both endogenous toxins (lipofuscin from cellular waste products) and exogenous toxins from the environment.  This accumulation of toxins makes older cells more susceptible to developing mutations in their DNA resulting in cancers.  Thus, their elimination is desirable.   However, if cell turnover is too frequent, telomere length shortens prematurely.
  • Metabolic rate and free radical activity.  These are the main driving forces of cell breakdown and turnover.  The food we eat and the activity we do or do not engage in has a profound effect on these factors.  For example, bursts of exercise temporarily create increased metabolism and free radicals.  In moderation, this leads to a healthy, cleansing turnover of cells.  Another scenario is caloric restriction. When the body thinks it’s starving, almost all physiological processes slow to a trickle.  The slowing of metabolism reduces the production of cellular waste products and free radicals posing less risk of cancer.  As the turnover of cells also slows telomere length is conserved.

Because bone health is strongly related to the health of so many other tissues in the body I’m going to look at bones as an example of how to manipulate aging factors with diet.  Simplistically, bones are made of a protein lattice with a bunch of minerals held in that lattice with vitamins D and K acting as the glue.  In addition to providing structural integrity for the body, bones act as a mineral reservoir for times of dietary scarcity.  A keystone function of our bone mineral reserve is to maintain the very sensitive and narrow pH range of the blood and intracellular fluids.  The body must keep these fluids at a slightly alkaline pH 7.35-7.45 or several physiological functions begin to fail including:

  • Increased consumption and reduced production of ATP,
  • Accelerated bone loss
  • Increased membrane free-radical production
  • Less efficient metabolism and protein synthesis
  • Suppression of growth hormone and other pituitary hormones. 

(*the above bullets were obtained from an article written by Susan Brown PhD.  See article link at bottom)

Every time we eat acidifying foods, like protein, the blood or cytoplasm pH falls toward a more acidic state.  In response, the body uses its bones to buffer the acid like a Tums™ tablet.  It does this by activating cells called osteoclasts that create inflammatory chemicals that break down bone to release buffering minerals like potassium, calcium and magnesium into the blood and cytoplasm.  When we eat a meal of alkalizing foods, like kale or almonds, cells called osteoblasts are activated to rebuild the bone structure.  If the diet is relatively alkalizing, containing lots of minerals, these cells don’t need to be as active. Unfortunately, even what we consider healthy diets are quite acidifying.  This causes a constant flip flop of increased metabolism of these two types of cells.  Remember from above, increased metabolism will lead to faster cell turnover and speeds the shortening of telomeres.

From my 10+ year of practice I can say with certainty that if there is one thing people are lacking more than anything else in their diets its minerals.  By the way, guess what gives your hair its color.  Traditional Chinese Medicine states that the state of the hair reflects the state of the bones.  I don’t think this is scientifically proven but I would imagine a good study would show a correlation between the graying of hair and the deterioration of bone health.

SIMPLE CHANGES THAT CAN MAKE A HUGE DIFFERENCE:

Include more alkalizing foods in with every meal: 

  • Green tea
  • Sea Salt (very alkalizing and high in minerals)
  • Drink mineral water throughout the day
  • Conclude your meal with an Umeboshi plum – one of the most alkalizing foods
  • Include lemon or lime in your water – yes they are acidic but have an alkalizing effect on the blood
  • Eat mineral-rich organ meats like kidney, heart and liver.  They taste like minerals and we aren’t used to these exotic tastes anymore
  • Eat fish like sardines and canned wild salmon which contain digestible bones
  • When you make soup, make it with the whole carcass
  • Eat more miso soup with extra seaweed

Combine alkalizing veggies with every meal.  This is especially important because all protein sources are somewhat acidic and you have to eat protein.  To balance out this acidity include foods like broccoli, cauliflower, onion, daikon, garlic, parsley, collard greens, mustard greens, arugula, watercress, ginger root, cabbage pumpkin, bell pepper, sea weeds and sea veggies. This is why if you do the Atkins diet, you MUST eat lots of veggies with it.  

After exercise  consume miso soup with seaweed which is loaded with potassium, magnesium and other trace minerals  OR take a potassium-magnesium supplement.  Even those E-Mergen-C packets are pretty good especially if combined with a greens mix.

Eliminate bone-dissolving “foods” like all sodas, coffee, sugar and high sodium foods.

Don’t be fooled by some “healthy foods”.  For example carrots, zucchini, spinach and chard contain calcium but are actually acidifying and can induce bone turnover.

Ensure your body is capable of absorbing minerals:  The ionization that occurs in stomach acid is the rate-limiting step for mineral absorption.  If you are on acid-blocking medications like Zantac™, Prilosec™, or Protonix™, your body is virtually rendered incapable of absorbing minerals (protein as well).  My suggestion, find a doctor, naturopath or Chinese Medicine doctor who practices functional medicine and get it fixed.  In the meantime, focus on avoiding acidifying foods and consume more alkalizing foods to minimize the damage.

Some Helpful Supplements that I know work:  You can take all the supplements you want but if your diet continues to induce and acid state, you cannot slow down the constant metabolism in bone tissue.

  • Kelp tablets especially the brand Katsu
  • Dalektro-N – this is a German biologic drainage remedy that seems to magically improve mineral absorption
  • Multi-mineral supplements – not advisable for people with weak digestion.  Kelp is better.
  • Osteoforce by Designs for Health
  • Greens mix such as barley greens or Paleogreens

For a complete list of foods see The Acid-Alkaline Food Guide by Susan Brown, PhD.

Susan also has a fantastically researched article expanding on the subject of acid-alkaline balance, bone health and its effects on the rest of the body.  http://www.ionizers.org/pdf/bjaffe.pdf

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